# EBRAHIM HAKIMIAN, M.D. INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CEDARS HEALTH CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699914937
- **Authorized official:** DR. EBRAHIM HAKIMIAN M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 909-9868

## Contact information

- **Practice address:** 14649 VICTORY BLVD, 22, VAN NUYS, CA 91411-4101
- **Practice address phone:** (818) 909-9868
- **Practice address fax:** (818) 909-9871
- **Mailing address:** 14649 VICTORY BLVD, 22, VAN NUYS, CA 91411-4101
- **Mailing address phone:** (818) 909-9868
- **Mailing address fax:** (818) 909-9871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A48918 | CA | Yes |

## Other

- **Enumeration date:** 02/10/2009
- **Last updated:** 06/16/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A489180 | — | CA |
| 01 | — | BL178 | MEDICARE PROVIDER NUMBER | CA |